This time last year life had become a struggle for Ron Rigby, who was facing a growing number of health problems.

‘I like to be independent, but walking had become difficult because my feet were so badly swollen – I had to keep buying bigger and bigger shoes,’ says Ron, 88, a retired heating engineer who is widowed.

‘I had terrible insomnia, too. For about two years, I would get by on a few hours’ sleep a night.’

But a meeting last summer would prove transformational for the father of three.

He has since regained his mobility, shed a stone in weight, is sleeping through the night – and has an improved outlook on life as a result.

It wasn’t a new medication that helped – quite the opposite. What transformed Ron’s health was cutting down the number of pills he takes daily.

Having relocated from London to Poole, Dorset, to be near his daughter Loraine, 67, Ron – who had ‘a whole cupboard in my kitchen for all my tablets’ – was offered a review of the medication he was taking (known as a structured medication review, SMR), as he had enrolled at a new GP practice.

He had been taking ten of the drugs since having a heart bypass in 1995.

As a result of a structured medication review, Ron Rigby, 88, has regained his mobility, lost a stone in weight, is sleeping consistently and has an improved outlook on life

But the medication review led to a reduction in the number of tablets he took daily, from 14 to nine – with the result that he now feels like a new man.

Out went the lacidipine, which reduces blood pressure (but can also cause fluid to redistribute, especially in the lower legs and ankles – hence Ron’s swollen feet).

Out too went the anti-diuretics (indapamide and furosemide) he was taking to stop his feet from swelling but that were making him pee more and interrupting his sleep. Tests revealed that the furosemide, which forces the kidneys to expel excess salt and water, had caused Ron’s kidney function to decline. He says: ‘I feel so much better now. I can walk about, do my own cooking and I’m enjoying life.’

He has thrown out the extra-roomy shoes he had to buy to fit his swollen feet and says: ‘I’ve even been able to get my golf shoes back on and play the game I love again. I’ve got 13 grandchildren and 16 great-grandchildren, so that keeps me busy,’ and having previously been virtually housebound, he now says: ‘I am just back from Spain.’

Ron’s situation is far from unique. In the UK, 8.4 million people regularly take five or more medications a day and 3.8 million take eight or more, according to figures from the Department of Health and Social Care. Some people take as many as 40 different types of medication daily.

‘Appropriate combinations of multiple medicines can be good for a person’s health – but the data is also very clear that the wrong combinations of multiple medicines for an individual can also be very bad,’ says Steve Williams, a clinical pharmacist at Poole Bay and Bournemouth Primary Care Network, who carried out Ron’s medication review.

Indeed, many will be given extra drugs to counter the effect of other medication, he says. ‘I have seen it many times before. Typically, one drug causes a side-effect, which leads to another prescription, which causes further problems, which require more medication – it becomes a vicious cycle.

‘If you keep adding and never subtracting, you multiply the harm.’

In fact, every year there are one million emergency hospital admissions to the NHS in England because of harmful side-effects from medication. This represents 16.5 per cent of all unplanned admissions to hospital. 

And at least 40 per cent of them are preventable, according to figures from the Health Innovation Network (an NHS organisation that brings together medics, academics and industry), presented at a recent conference on polypharmacy – the use of multiple drugs at once.

Older people are especially at risk because not only are they likely to be taking multiple medications but also the way the body responds to medicines changes with age. For example, the liver and other organs start to process them differently.

That can mean a drug that once suited them well may have a stronger effect, or bring a higher risk of side-effects – and so the dose might need to be changed or the medicine stopped altogether, says Steve Williams.

Without SMRs, people may continue on drugs they don’t need or that do more harm than good and suffer adverse effects such as falls because of low blood pressure or low blood sugar, he adds.

Ron’s case is a good example: he was on two different blood pressure-lowering medications, ‘but these were having such a strong effect together that we actually found his blood pressure was too low’, says Steve Williams.

Ron now has a new lease of life and with 13 grandchildren and 16 great-grandchildren, he is excited to spend more time with his family

‘So we were gradually able to reduce the doses with careful monitoring. His blood pressure is now back to normal range.’

An SMR (also known as a medicine MOT), as Ron had, can identify problems with a drug regimen. Indeed, the National Institute for Health and Care Excellence (NICE) recommends that all those taking multiple medicines, those with long-term health conditions and older people have a review every year.

‘Data suggests upwards of three million people need a medication review annually,’ says Zoe Girdis, a pharmacist and fellow of the Royal College of Pharmacy. But many are missing out – and the situation could get worse.

An SMR involves a clinician reviewing the patient’s medications to check they are still necessary and that they’re having the desired impact. This is typically carried out by a pharmacist. But as Parliament’s Public Accounts Committee pointed out in a recent new report, too few of those who need medication reviews are actually getting them.

‘GPs are failing to properly assess and support people with, or at risk of developing, frailty. Of the 226,000 patients diagnosed with severe frailty in 2024/25, only 16 per cent had a medication review,’ the report said.

‘Thousands of patients need medication MOTs but they haven’t had them – because there isn’t the capacity or skills to provide them currently in the system,’ says Steve Williams.

Using SMRs to manage over-prescribing and problems of polypharmacy was started by a group of GPs and pharmacists trying to reduce the volume of unnecessary medicines across some GP surgeries in Wessex in 2008.

Its success led to the development of a structured three-step programme across England, called the Polypharmacy Programme. It involves using GP records to identify patients in need of a medication review, as well as educating GPs to be more confident about stopping unnecessary medicines – and sometimes not starting patients on them in the first place.

‘As doctors, we’re trained to prescribe – but not to deprescribe,’ says Dr Lawrence Brad, a fellow of the Royal College of GPs who was one of the original Wessex GPs behind the approach.

‘It’s never been taught to us and so the net result is that patients – especially older patients – have the increasing potential to end up on ten-plus medicines per day.

‘I’ve known patients to be on up to 25 different medication types per day.’

The third strand of the initiative is running patient education campaigns in GP surgeries to change their perception of needing ‘a pill for every ill’ and to encourage them to be more questioning about their medication.

Last year, economic modelling of the impact of the deprescribing programme nationwide showed that it would not only reduce the number of unnecessary medicines prescribed to patients over a three-year period (from 2022/23) but for just three types of medicine it would also save the NHS £1.1million in drug costs. There will also be significant savings from fewer hospital admissions.

Steve Williams says: ‘With this deprescribing approach, we can make patients feel better and free up the system so that there are more appointments for people who have undiagnosed conditions or who are acutely unwell.’

The deprescribing programme will not only reduce the number of patients on unnecessary medications, improving health outcomes, but will also save the NHS millions

However, despite its success, last September programme managers said they had been unsuccessful in securing its future because of a lack of ongoing funding as part of the Government’s wider plan to abolish and restructure NHS England.

Clare Howard, a pharmacist and clinical lead for the programme, warned that once the work is paused, it would be ‘really difficult to resurrect it’ and that without continued funding, training will cease and the momentum of the initiative will be lost.

In an 11th-hour rescue, the team secured charitable donations from the Vivensa Foundation, which funds research into ageing well, which will see the Polypharmacy Programme continue until March 2027. Beyond that, its future remains in doubt – even though the NHS acknowledges how useful it is.

A spokesperson for NHS England told Good Health: ‘Over three years, this programme has been vital in training doctors how to reduce inappropriate prescribing and also how to train their colleagues to do the same.’

The end of such training would be bad news for patients like Ron, who would otherwise continue to be put on more and more medications despite unwanted side-effects.

There are some drugs doctors simply fail to stop prescribing, says Steve Williams.

A typical case, he says, is people remaining on blood thinners that were only intended to be given as a short course to reduce the risk of blood clots, but the prescription is not reviewed (and taken longer term, the drugs can cause internal bleeds). Another example, he says, is people remaining on GLP-1 obesity drugs, even after they have lost a lot of weight, which means they are at risk of dangerously low blood sugar.

He points to the example of a patient he dealt with, an 83-year-old widower, who had atrial fibrillation (an irregular heartbeat), diabetes and who last year had an operation on his prostate.

He was admitted to hospital with severe constipation after the urologist and cardiologist had both separately prescribed pills that can cause it. It was not until an SMR was conducted after hospital that the medication errors were noticed and resolved.

‘And you can’t just put a red line through a prescription, you have to review everything and deprescribe in a safe, controlled way, often carefully tapering the dose,’ says Steve Williams.

Sometimes you need to adjust, remove or add to the prescriptions, he says. In Ron’s case, as well as cutting out five tablets that were interacting and worsening side-effects, it was discovered that his insomnia was down to a painful knee because of osteoarthritis (which he hadn’t sought help for). His GP later prescribed amitriptyline to manage his nerve pain.

Another reason SMRs are vital is to ensure patients take their medications correctly: around 50 per cent of all patients don’t – and ‘this is compounded by having multiple things you need to take’, says Dr Brad.

‘The logistics become trickier if you have one thing that needs to be taken on an empty stomach, but two others that must be taken with food – and different pills that need to be taken at different intervals etc.

‘We know that almost a fifth of emergency cases admitted to hospitals [16.5 per cent] are due to harm caused by taking prescribed medicines – and taking multiple medicines increases this risk.

‘And emergency admissions to hospital – certainly the first two days – are pretty much the most expensive activity in NHS care costs. So that all adds up to an enormous drain on NHS resources.’

The total bill for prescriptions is rising year on year. In 2024/25 the NHS spent £21.6billion in England, up from £20.5billion in 2023/24. But it isn’t only about money – it is also a question of needless suffering.

Prior to her medication review, Tracy Smith, 59, a retired nurse from Burnley, was taking 21 tablets daily to cope with a range of ailments, including emphysema and fibromyalgia.

She also has osteoarthritis in both knees and pancreas divisum, a congenital condition where the pancreas has one drainage tube instead of two, causing recurrent inflammation and pain.

‘I was just having medicines added, but I didn’t feel much better,’ says Tracy, a mother of three and grandmother of ten.

‘I experienced side-effects such as a dry mouth and weight gain. I felt like I was constantly in a daze.’

Among the medications she was on were pregabalin, an analgesic used to treat nerve pain.

‘I was on 300mg twice a day and it caused a lot of side-effects,’ she says. ‘I was very tired, had terrible brain fog and I felt drugged up. I just couldn’t get my words out.’

She was under the care of specialists for her pancreas divisum and a clinical pharmacist was assigned to conduct her medication MOT. After starting on a six-month gradual deprescribing process, Tracy is now down to eight medications a day.

The pregabalin was stopped altogether, as well as two opioid painkillers, a muscle relaxant and nerve pain medication. The dose of an antidepressant she’s taking has been reduced by two-thirds (from 75mg to 25mg per day). ‘I feel so much better in the head and myself,’ she says. ‘I think the deprescribing process was really good because I just felt listened to and supported to reduce the medicines gradually.’

Tracy is now enjoying time in her allotment, teaching her great-grandson, Oliver, ten, how to grow grapes and kiwis. She says: ‘I’m less sluggish, no longer have brain fog – and even though some of the pain medication has been removed, my pain hasn’t increased.

‘I’m much better off now that the number of tablets I’m taking each day has reduced.’

So what should anyone do if they are worried about the medication they are on?

Steve Williams says: ‘Don’t stop them without advice. Contact your GP surgery and ask if you can have an SMR to check that all your medicines are working for you.’

But the bottom line is that patients need more help to ensure they only take the medication they need.

‘Patients deserve better than a system that only knows how to add drugs,’ says Zoe Girdis.

‘We cannot ignore this problem any longer. As our population ages and we treat more conditions, more medicines are prescribed but are just multiplying the harm.’

‘This is a system problem, not a prescriber problem,’ she adds. ‘Clinicians are working within a framework that incentivises prescribing and offers nothing for deprescribing.

‘When I ask a frail older person what they want from their health, the answer is rarely another tablet. It is years of healthy life.’

As Britain braces for a potentially record-breaking heatwave, millions of people are looking for the best way to keep cool.

A powerful ‘heat dome’ settling over western Europe is expected to send temperatures soaring beyond June’s record of 35.6C today, with some forecasters predicting highs of up to 38C in parts of the UK.

With the tropical conditions set to continue this week, Britain’s hottest-ever temperature of 40.3C, set during the famous heatwave in 2022, could also be broken.

As health chiefs issue a ‘red alert’ weather warning – meaning there is a risk to life for citizens – there are important questions being asked: Should the blinds be closed during the day? Is it safe to sleep with an electric fan running? Would changing your bedsheets help you stay cooler at night?

There are health concerns, too: How much water should you really be drinking? Is there such a thing as drinking too much? And when it comes to cooling down, is a cold shower actually the best option?  

With so much to consider, it can be difficult to know what is best to do. So, to find the most effective way to handle the heat, we asked experts for their top tips on staying comfortable and safe.

People shade from the sun under umbrellas on the River Cam, Cambridge

Keeping your home cool

Trying to keep your home at a comfortable temperature can be difficult, particularly if you are going to be in your workplace for much of the day and unable to control conditions as temperatures rise.

Dr Ben Roberts, senior lecturer in healthy buildings at Loughborough University, tells the Daily Mail: ‘Traditionally we’ve been a quite a cold country so we’ve been looking at keeping our houses warm in winter. 

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‘It’s only since 2022 that we’ve had building regulations which have started to look at keeping our homes cool in summer. So, we’ve got a bit of catching up to do.

‘We see thousands of excess summer deaths, and those are deaths that wouldn’t have ordinarily happened had it not been for some kind of heatwave event. It is affecting people’s health and wellbeing, and at worst it’s killing people.’

This raises the question of whether blinds should be kept down, windows left open, and fans kept on.

But the answers can vary depending on the type of property you live in. 

Top-floor flats, for example, tend to become hotter as heat rises, while homes with larger windows can also warm up rapidly in direct sunlight and shaded properties may be far cooler. 

As a general rule of thumb, however, Dr Roberts advises that most people should always put their blinds down during the day. 

He said: ‘If they are light in colour, or some kind of reflective metal, then it is worthwhile keeping your internal blinds or curtains closed during the day to stop the sun’s heat coming in because it will reflect some of that heat back out.’

For ventilation, the best approach is to open windows on opposite sides of a home during the coolest parts of the day, typically overnight or in the early morning, when temperatures are at their lowest. 

Creating airflow through the home in this way allows cooler air to circulate more effectively than opening windows on just one side of the property. 

Dr Roberts said: ‘Whenever it’s warmer outside than in, opening your windows just lets that hot air in. The general advice is that, during the peak of the day during heatwaves, it’s almost always that it’s going to be hotter outside than in – so that’s when you should be keeping your windows closed.

People seek shade, use umbrellas and fans, and spend time in parks

‘Then at night, when it’s likely to be cooler outside than in, that’s when you should open your windows if it’s safe to do so.

‘Obviously for a lot of people, especially if they’re living in ground floor flats or noisy polluted areas, there’s a variety of reasons why people might not want to open their windows. But the general advice is open your windows at night close them during the day during heatwaves.’

If a home has only one window, a fan positioned nearby can help move cooler outside air further into the room and improve flow throughout the property. 

Leaving a fan on during the day, however, is not advised by experts.

Dr Roberts says: ‘There’s no benefit to having a fan on if you’re not in the home because all the fan is doing is it’s moving the air – it’s not changing the temperature of the air.

‘Unless you’re there to receive that air movement and feel that air movement across your skin, and to have that additional sweat evaporation that the fan creates, it’s doing nothing.’

How to dress

It’s often difficult to know what to wear when the temperatures rise, especially for those working in offices where formal dress codes are still expected.

While it may seem logical to wear as little clothing as possible, experts say loose, lightweight layers are often more effective at keeping the body cool than exposing more skin while wearing heavier fabrics. 

Natural materials such as linen and cotton are among the best choices, as they allow air to circulate more freely and help the body control its temperature. 

Traditional office attire can also be adapted by opting for lighter shirts and trousers made from breathable fabrics. 

Loose-fitting clothing is generally recommended, as tighter garments can trap heat and restrict airflow. 

Official guidance from the UKHSA also advises people to wear sunglasses and a hat when outdoors, particularly during the hottest part of the day, and to apply sunscreen regularly.

A wide-brimmed hat is considered especially effective, as it provides shade for the face, eyes and neck, helping to reduce exposure to direct sunlight. 

A person uses an electric fan to cool down on the London Underground

Swimmers at Cullercoats Bay, North Tyneside, in the north east of England

What to do at bedtime

Trying to sleep during a heatwave is often one of the most frustrating parts of hot weather.

Tossing and turning, waking up drenched in sweat and feeling as though your bedroom has become a sauna, can make getting a good night’s rest seem impossible.

Fortunately, experts say there are several steps that can help improve sleep quality during the sizzling temperatures.

One of the easiest ways is to pay attention to bedding. Warm conditions cause the body to sweat more, while increased oil production and higher temperatures can encourage the growth of bacteria. 

As a result, experts recommend washing and changing bedsheets more frequently during the summer months, ideally around once a week. 

Heavy duvets should also be swapped for lighter alternatives where possible. Some people may even find they are more comfortable sleeping under a thin cotton sheet, with no duvet at all.  

Fans can also help, though Dr Punam Krishan, an NHS GP, says many people do not fully understand how they work. 

She says: ‘A fan doesn’t actually lower the temperature of a room. It works by moving air across your skin, helping sweat evaporate more efficiently and allowing your body to lose heat. During warm weather this can improve comfort and help some people feel cooler overnight although, in very extreme heat, a fan on its own may be less effective and additional cooling measures may be needed.

‘So, while methods such as opening windows and using electric fans to cool your room’s temperature are widely recognised, it’s important to also focus on cooling down your body. This is particularly essential for older adults who often sleep lighter and feel heat more acutely as the body’s temperature regulation becomes less efficient with age.’

People on a boat in Stratford-upon-Avon in Warwickshire on Monday June 22, 2026

Sun worshippers enjoy the weather on the River Cam in Cambridge, on Monday, June 22, 2026

Another way Dr Punam recommends to beat the heat is by taking a lukewarm shower rather than a cold one. 

She says this can ‘work wonders’ because it draws warm blood away from the core and towards the skin, where it can cool in the air.

Dr Punam also advised keeping water by the bed because it can help prevent dehydration , while alcohol is best avoided as it can also contribute to dehydration.

Furthermore, once in bed, she says sleeping with wrists, ankles and neck outside of the covers can help to stay cool.

Don’t overdo the simple things

Certain groups are more vulnerable to the effects of extreme heat than others – and must take more care during the hottest days. 

Those most at risk of serious complications from overheating include adults aged over 65, young children under five, people with long-term health conditions, particularly heart and breathing problems, pregnant women, and those who live alone, according to the UKHSA.

As temperatures rise, experts advise everyone – particularly those in higher-risk groups – to avoid unnecessary activities that could increase their body temperature or make overheating more likely. 

That includes household chores such as cooking, cleaning and laundry, because ovens, hobs, tumble dryers and washing machines can generate significant amounts of heat and, in turn, raising temperatures. 

Where possible, people are encouraged to choose lighter meals that require little or no cooking, such as salads, fruit and other cold foods. 

It’s also key to recognise the warning signs of heat-related illness. 

Symptoms of heat exhaustion can include dizziness, weakness, sweating, nausea, headaches, muscle cramps and clammy skin.

Signs of life-threatening heatstroke, meanwhile, can include confusion, nausea and loss of consciousness. A person may have very hot skin and a body temperature above 40C, but may stop sweating.

Anyone suspected of suffering from heatstroke should be treated as a medical emergency and emergency services should be contacted immediately. 

A person drinks water at Parliament Square, central London, on Monday June 22, 2026

Stay hydrated

Becoming dehydrated is one of the biggest risks to human health during a heatwave because as temperatures rise, the body produces more sweat in an attempt to cool itself down. 

While this is essential to keep the body functioning, it also causes the body to lose large amounts of fluid, increasing the risk of dehydration if not replenished.

Adults are typically advised to drink between six and eight glasses of fluid a day – roughly 1.5 to 2 litres. 

However, experts believe people may need to increase their intake during periods of extreme heat, with up to three litres often recommended.

The NHS advises people to drink fluids regularly throughout the day when the weather is hot, even if they do not feel thirsty, and to opt for cold drinks where possible.

It is also advised that alcohol is avoided during hot weather, while caffeinated and hot drinks should be limited. As they are diuretics – meaning they take more fluid from the body – this can contribute to dehydration.

Dehydration can become serious if left untreated and, in extreme cases, can be fatal.

Common symptoms include feeling thirsty, headaches, dizziness or light-headedness, fatigue, a dry mouth, lips and tongue, and passing dark yellow or strong-smelling urine. People may also find they are urinating less often than usual.

More severe dehydration can cause confusion, sunken eyes, rapid breathing and a rapid heartbeat. 

There are also dangers of having too much water – overhydration. 

In some cases, excessive water intake can overwhelm the body’s ability to maintain the correct balance of electrolytes, particularly sodium, leading to a condition known as hyponatraemia.

When this happens, water flows through the body’s cells in an attempt to restore balance, causing them to swell, which can be dangerous and lead to symptoms including headaches, confusion, nausea, vomiting and, in severe cases, seizures or loss of consciousness.

Overhydration is most likely to occur when large amounts of water are consumed in a short period – causing the body to be overwhelmed.

Visiting air-conditioned and shaded facilities 

For those struggling to keep cool at home, experts recommend spending time in air-conditioned or shaded public spaces during the hottest parts of the day.

While air conditioning remains relatively uncommon in many UK homes, it is found in places such as shopping centres, cinemas, libraries and museums. 

Even a few hours spent in a cooler environment can help reduce the strain heat places on the body.

Public parks and green spaces can also provide relief from the heat, particularly areas with tree cover and plenty of shade. 

A ‘pollen bomb’ is set to wreak havoc across Britain this week, triggering debilitating symptoms for the nation’s 13 million hay fever sufferers.

The UK is on course to see record-breaking June temperatures of 38C today, and those with pollen allergies – officially known as hay fever – are being warned to brace themselves.

An incurable allergic condition, hay fever can cause splitting headaches, extreme fatigue, sneezing, coughing, blocked or runny noses, itchy eyes and sore throats. 

And symptoms could be set to become even more severe, as the combination of sizzling ‘heat dome’ temperatures and ‘very high’ pollen levels will see huge quantities of allergy-causing pollen particles released into the air.

Experts say the nature of this summer’s ‘stop-start’ weather has created the perfect conditions for a so-called ‘pollen bomb’.

Normally, pollen from trees and grass are released at different times, but fluctuating conditions are believed to have caused both to overlap and release at the same time.  This triggers high concentrations of pollen in the air, increasing the chance of allergic reactions when the particles come into contact with the eyes, nose, throat and mouth.

Thankfully for millions, experts say there are several ways to protect yourself against the dreaded ‘pollen bomb’ beyond reaching for an antihistamine – the most common form of protection, which is taken in a tablet form.

Read on for their top tips.

A ‘pollen bomb’ is wreaking havoc on Britain this week, triggering debilitating symptoms for the nation’s 13million hay fever sufferers

Take antihistamines 

Professor Adam Fox, a paediatric allergist, told The Telegraph: ‘We know that the combination of regular antihistamine use alongside nasal steroid sprays is safe and will significantly improve the symptoms of 85 per cent of patients, provided they take them regularly. 

‘Taking precautions and using products that deliver fast and effective relief is key.’

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Fox, who is one of the UK’s leading allergy specialists, recommends fexofenadine as his antihistamine of choice for hay fever sufferers. 

Antihistamines work by blocking histamine, which is released by the body’s immune system releases when it reacts to pollen.

Fox says patients report experiencing fewer drowsy side effects when taking fexofenadine – which is available over the counter – compared with other tablets.

Some antihistamines, such as Piriton, which contains chlorphenamine, are well known for causing sleepiness. Other non-drowsy alternatives include Claritin, which contains loratadine, and cetirizine hydrochloride are also popular.

Nasal sprays can help  

However, experts say the tablets are not the only way to tackle severe symptoms. 

Dr Adrian Morris, a consultant allergist at the Surrey Allergy Clinic, says nasal corticosteroids – medications that are typically sprayed up the nostril to reduce inflammation – can also help.

Though they generally take around a week to work, Morris says prescribed steroids such as prednisolone may provide faster relief in more severe instances.

He also recommends decongestants, which work by reducing the swelling of the blood vessels in the nose, in turn opening the airways and relieve blockages.

Decongestants can also be dangerously addictive, though, so Morris warns that they should not be used for longer than a day or two. 

Another treatment option is the use of leukotriene modifiers, drugs commonly used to treat asthma attacks.

The drugs work by blocking chemicals involved in allergic reactions and are sometimes used in particularly severe cases of hay fever.

Fox says leukotriene modifiers are typically reserved for patients whose symptoms persist despite other treatments, including immunotherapy – a process that gradually trains the immune system to tolerate pollen, sometimes over a course of years.

Sizzling temperatures combined with very high levels of pollen is triggering a ‘pollen bomb’ 

He believes that, while an option, the use of leukotriene modifiers ‘doesn’t fit for most people’ and that the natural progression would be to go from antihistamines, to nasal sprays, and then immunotherapy.

Don’t shrug off nasal rinses 

Even after trying all of the conventional methods, some sufferers still can’t shake their hay fever – and look to alternative remedies.

One such option is a nasal rinse, which involves flushing out the nasal passages with a salt-water solution to wash away pollen.

Devotees use warm, previously boiled and cooled water mixed with a teaspoon of salt and bicarbonate of soda. The water then runs through the nose and comes out of the mouth, getting rid of the pollen. Ready-made kits to do so are widely available from pharmacies.

Fox believes this method is ‘bound to be helpful’ as it removes the pollen, and says he recommends it to people just before they use a steroid nasal spray.

Other, more rare methods, include light therapy – where infrared lights are beamed into the nose in a bid to reduce inflammation caused by allergies. Fox remains skeptical but dubs it as ‘one to watch’.

Ectoin sprays, which, like the official NHS guidance to coat the nostrils in Vaseline, essentially act as a barrier to pollen from entering the nostrils and are also seen as promising by experts.

Look at your diet… and other quirky advice 

Another method, which has less scientific evidence, is quercetin – an antioxidant found in foods such as red apples and red onions, as well as purple grapes, kale and broccoli. 

Limited studies show it may have antihistamine effects by blocking the release of histamine, but it should not be seen as an official treatment.

Experts advise more quirky methods, too, such as buying an air purifier for homes – which they say can rid the air of any pollen that enters the property.

Pet owners are also advised to wipe down their animals after walks, as pollen can cling to fur and be carried into the home.

NHS England says visits to its website for hay fever advice have doubled due to the ‘heat dome’ hitting the UK, with concerned allergy-ridden Britons seeking advice on how to stay safe. 

Official NHS guidance recommends applying a thin layer of petroleum jelly, such as Vaseline, around the nostrils to help trap pollen particles before they enter through the nose. 

Wearing wraparound sunglasses, a face mask or a wide hat can also help reduce exposure.

Going for a shower is also encouraged to wash pollen off, as is keeping windows and doors closed, vacuuming regularly and wiping down dusty surfaces.

The NHS says to avoid activities that increase contact with pollen, such as cutting or walking through grass or spending extended periods outdoors. Keeping fresh flowers indoors may also worsen symptoms.

Other triggers include cigarette smoke and drying clothes outside, which can allow pollen to collect on fabrics.

Pharmacists can provide advice on the most appropriate treatments, including antihistamines, nasal sprays and eye drops.

Hiking in Peru, Lucy Schoonhoven realised with some alarm that she couldn’t make out the sides of the mountain path she was walking on.

‘I felt unsafe,’ she recalls. ‘I couldn’t see the edges because every time I looked down, it was like I had a mass of cloudy seaweed in front of my eyes.’

The vision problem wasn’t new. Lucy had started getting a few ‘floaters’ – small dots or strands that drifted across her vision – in her late 40s.

But the 59-year-old gardener says: ‘Once I hit 50 they increased a lot over a short space of time and it was like I had Vaseline on my eyes all the time.’

Floaters are a natural consequence of ageing. As we get older, the vitreous gel – the jelly-like substance inside the eyeball – becomes more liquid, allowing strands of collagen (protein fibres in the gel) to clump together.

These clumps then break away and float around in the main body of the gel.

This debris is what we see as floaters when they cast shadows on the retina – the area at the back of the eye that converts light into visual signals sent to the brain to produce sight.

‘This process happens in everyone’s eyes and can’t be prevented,’ explains Mahi Muqit, a consultant ophthalmic surgeon at Moorfields Eye Hospital in London and spokesman for the Royal College of Ophthalmologists. Generally, they’re not a problem. Most people will get some floaters between their late 30s and their 50s, but the brain can usually shut off the signals from their shadows effectively, so we don’t notice them, he explains.

Lucy Schoonhoven started getting a few ‘floaters’ – small dots or strands that drifted across her vision – in her late 40s

But they can become debilitating. As Louisa Wickham, a consultant vitreoretinal surgeon and medical director at Moorfields, explains: ‘For some, the floaters can be very large or form large sheets which can be described as like a smoke screen, spider’s web or lace curtain.

‘In these cases, the floaters can sometimes sit centrally in a person’s vision, making it difficult to drive, read or use a computer.’

Floaters can also affect the ability to see contrast – for example, being able to distinguish between two shades of the same colour.

For Lucy, a mother-of-two who lives in Fulham, west London, with her husband Julius, 54, a clock conservator, having permanent floaters was ‘incredibly demoralising and exhausting’.

In the years leading up to the Peru trip in November 2023, Lucy says she’d gone from being an ‘incredibly positive’ person to constantly feeling low.

That day on the mountain was ‘the final straw’.

It meant hiking was yet another of the things she loved that she felt was being taken away.

She’d already changed her job in 2020 due to the floaters, having been a book conservator working with rare or historical books and manuscripts.

Floaters are a natural consequence of ageing. As we get older, vitreous gel – the jelly-like substance inside the eyeball – becomes more liquid, allowing collagen to clump together

She explains: ‘It involved a lot of close-up work which made me very tired as my brain was working extra hard to get my eyes to focus with the floaters. So I became a gardener, something I’d always done as a side line.’

By late 2023, Lucy says she was struggling to read for any length of time, adding: ‘I also didn’t have the confidence to drive at night because the headlights hitting my floaters made it hard to see.

‘I was only 56 and I wasn’t sure if I could carry on living the life I’d been accustomed to with these eyes. I felt so low and miserable.’

Lucy is not alone in this. A paper published in the journal International Ophthalmology in 2024 found that people who had floaters experienced a significantly higher incidence of depression and anxiety than people who don’t have them.

While small floaters that have been present a long time or don’t have an impact on daily life are fine to ignore, a sudden increase is alarming and should always be investigated, says Mr Muqit.

Your first port of call should be an optician, who can do an optical coherence tomography scan (OCT), which takes an image of the retina and vitreous gel.

Floaters appearing suddenly can be a sign of inflammation or bleeding in the eye, Ms Wickham says. For this reason, people with diabetes can be more prone to floaters because advanced cases of the disease can affect blood vessels in the eye.

They’re also more common among the very short-sighted, who may get them earlier – ‘often in their 20s or 30 because their eyes are slightly longer, which means they have a larger volume of vitreous gel inside the eye, which can lead to it breaking down sooner’, adds Mr Muqit.

Meanwhile, lots of floaters that suddenly occur at the same time as flashing lights always need urgent attention.

While this could indicate a posterior vitreous detachment (when the vitreous gel has become so liquefied with age that it separates from the retina, which is usually harmless), it is important to rule out retinal tears and treat them as an emergency before they lead to a retinal detachment, says Paulo-Eduardo Stanga, a professor of ophthalmology at University College London and founder and chief medical officer of The Retina Clinic in London.

‘As the gel separates, floaters can be released due to the movement and the act of separation can excite the retina, causing flashing lights,’ explains Ms Wickham.

Although a vitreous detachment usually settles with time, a retinal tear requires urgent laser treatment and a retinal detachment requires urgent surgery, otherwise it can lead to permanent sight loss.

However, treatment is also available for floaters that aren’t strictly speaking a medical risk but are causing someone significant distress.

Unfortunately, many patients aren’t told about this – or are told there’s nothing that can be done and they need to get used to them, says Professor Stanga.

‘Surgery known as a vitrectomy is the gold-standard treatment,’ Mr Muqit says.

Done under local anaesthetic, it involves removing around 95 per cent of the vitreous gel through micro-incisions on the eyeball, which also removes the floaters. It takes 30 minutes in each eye.

‘The vitreous cavity is immediately filled up with clear aqueous fluid from the front of the eye,’ he says. New floaters won’t form as this new fluid does not contain collagen, unlike the vitreous gel.

Usually, vitrectomies are done privately, but they are offered in small numbers on the NHS for people who are severely impacted by floaters, says Mr Muqit.

‘They should be offered more on the NHS, but only if and when the NHS can cope with more urgent eye issues, which it can’t,’ adds Professor Stanga.

Treatment using an yttrium-aluminium-garnet laser – or YAG laser – is also available privately (at a cost of £900 or more). This uses laser energy to break up the collagen clumps that cause floaters. More than one round of treatment is often required.

‘However, there are no large-scale studies to show the efficacy or the safety of laser treatments, so they are not offered on the NHS,’ says Ms Wickham.

After that worrying moment on the mountain, Lucy went to see a retinal surgeon privately. She first saw him in 2020 after her optometrist recommended it when the floaters got worse.

At the time, when she was still able to read and carry on largely as normal, she felt too squeamish and nervous about the procedure to have it done.

However, in January 2024 Lucy had a vitrectomy in each eye, four weeks apart, as well as cataract surgery. She was advised to have both procedures done at once as a common side-effect of floater surgery is the risk of exacerbating cataracts, which is when the lens of the eye becomes cloudy, causing blurred vision.

The treatment cost her £27,000 – as Lucy explains: ‘My private health insurance covered a small amount but it was largely self-funded – I felt I had to use inheritance money I’d received to pay the rest because the floaters were ruining my life.

‘The recovery took a few weeks and involved using eye drops to dilate my pupils, which made everything blurry, but once I could stop using them as much, my eyesight was amazing.’

Dilating the pupils puts the eye at rest and reduces the risk of inflammation. She adds: ‘Now I can read and drive at night, I’m able to go hiking and travelling – I feel like I’m 35 again.

‘I had naively always taken for granted that I’d be able to do the things I love until old age, so I was shocked when my eyes became so debilitating in my 50s.

‘I don’t know what state I’d be in if I hadn’t had the surgery when I did.’

For the first time since a change in the law in the Netherlands, a child under the age of 12 has died by euthanasia. 

The death of the child was confirmed by the country’s health minister, Sophie Hermans, as she presented the annual report by the committee that reviews all late-term abortions and medically-assisted deaths of children to parliament on Monday.

According to the report, the child was under the age of 12 and had been seriously ill, but no further details were given. 

Assisted dying for terminally sick children aged from one to 12 has been legal for two years in the Netherlands. Before the change in the law, only newborns and those over 12 could be euthanised. 

Under Dutch law, parents must be consulted, the child must be suffering unbearably, and there can be no chance of recovery. 

The child’s death has been referred to the public prosecution service, which will decide if doctors complied with the rules surrounding euthanasia. 

The committee’s report will be made public shortly, Ms Hermans said. 

Under Dutch law, in cases of euthanasia, parents must be consulted, the child must be suffering unbearably and there can be no chance of recovery 

Euthanasia in the Netherlands is only permitted if the request comes from the patient and if a doctor agrees that they are suffering unbearably. 

The doctor must be satisfied that the patient is not acting under pressure and must obtain a second opinion.

Euthanasia has strong public support in the Netherlands, and the country became the first country to legalise it for those with incurable illnesses in 2002.

Before the law change, there was no clear euthanasia policy for children between the ages of one and 12 because they were believed to be unable to make their own decisions.

In England and Wales, a new attempt to legalise assisted dying was revived last week. 

Lauren Edwards, the Labour MP for Rochester and Strood, has announced she will reintroduce the Terminally Ill Adults (End of Life) Bill to Parliament.

The Bill, previously brought to Parliament in 2024, passed two votes in the House of Commons, but fell in the House of Lords, after peers ran out of time to conclude their debate before the end of the previous parliamentary session in April.

Ms Edwards has threatened to use rarely used powers under the Parliament Act to force it through if the Lords block it again.

Yet her efforts to push through assisted dying legislation in the new parliamentary session have been heavily criticised by other Labour MPs, amid their concerns about the time and political capital being expended on such a controversial issue.

Supporters of the Terminally Ill Adults (End of Life Bill), during a photocall at Parliament Square in London, ahead of a government petition debate in Westminster Hall earlier this month

Adam Jogee, the Labour MP for Newcastle-under-Lyme, said it was ‘insane’ to bring back the ‘deeply divisive and flawed Bill’.

Another Labour MP who is opposed to the Bill said: ‘The Labour Party needs the return of the assisted dying bill like we need a hole in the head.’

Former health minister Ashley Dalton, Labour MP for West Lancashire, who has terminal cancer, said: ‘I’m deeply concerned that supporters are bringing the assisted dying Bill back.

‘Voters put us in power to reduce the cost of living and fix the NHS. We have debated this deeply divisive and flawed assisted dying Bill for over a year and supporters have refused to listen or to make the necessary changes.

‘This Bill would hand sweeping unchecked powers over life and death and our NHS to future governments, whatever their political persuasion.

‘We should not be using more of our limited time and political capital on something that simply isn’t safe or a priority for the people who put us in power.’

Emma Lewell, Labour MP for South Shields, said she was ‘absolutely dismayed’ that the Bill is being reintroduced.

‘Not a single one of our major medical or professional bodies support it,’ she added.

‘A deeply flawed and dangerous Bill that poses a real risk to the most vulnerable in our society.’

David Smith, Labour MP for North Northumberland, said: ‘To bring assisted dying back now after it has so recently failed lacks wisdom.

‘It will only deepen division and distract the Government from far bigger priorities.’